- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,066.46 / $7,517.00 / $17,098.98
| Facility | | $2,066.46 | $7,517.00 | $17,098.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.59 / $1,024.67 / $4,584.00
| Professional | | $477.59 | $1,024.67 | $4,584.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.06 / $1,889.78 / $2,590.64
| Professional | | $1,122.06 | $1,889.78 | $2,590.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,860.00 / $10,338.04 / $19,997.13
| Facility | | $7,860.00 | $10,338.04 | $19,997.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $938.50 / $1,599.74 / $2,132.98
| Professional | | $938.50 | $1,599.74 | $2,132.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,714.00 / $2,352.98 / $3,154.48
| Professional | | $1,714.00 | $2,352.98 | $3,154.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $971.87 / $1,846.55 / $9,455.00
| Facility | | $971.87 | $1,846.55 | $9,455.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $272.26 / $1,887.52 / $1,887.52
| Facility | AS | $272.26 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,296.43 / $2,144.09 / $2,862.78
| Professional | | $1,296.43 | $2,144.09 | $2,862.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $2,571.88 / $6,670.60
| Facility | | $1,392.00 | $2,571.88 | $6,670.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,786.07 / $2,233.38 / $3,154.48
| Professional | | $1,786.07 | $2,233.38 | $3,154.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,035.09 / $1,907.11 / $7,317.51
| Professional | | $1,035.09 | $1,907.11 | $7,317.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,296.43 / $2,144.09 / $2,862.78
| Professional | | $1,296.43 | $2,144.09 | $2,862.78 |